Key Takeaways

 The Pfizer-BioNTech vaccine is approved for kids age 5 and up.

 Schools may eventually require COVID-19 vaccination alongside other
childhood vaccines, but not soon.
 Factors like full FDA approval and the risks of spreading and becoming
infected with COVID-19 will play a role in deciding if and when schools
will mandate the vaccine.

The Pfizer-BioNTech COVID-19 vaccine is available to all children 5 and up.

The vaccine has full U.S. Food and Drug Administration (FDA) approval for
use in those 16 and up and emergency use authorization (EUA) for ages 5 to
15.1 As school-age children have become eligible for vaccination, parents
wonder if public school systems could make it mandatory for students to get
vaccinated.

"Different schools will have different thresholds for creating mandates. There
are some that have already talked about instituting mandates; others may
wait," says Kawsar Talaat, MD, associate professor of international health at
the Johns Hopkins Bloomberg School of Public Health.

The vaccines are safe, the vaccines are effective,

and they are a good way to keep our kids healthy
and to keep our kids in school.
— KAWSAR TALAAT, MD

American public schools require children to receive all of the routine

vaccinations recommended by the American Academy of Pediatrics (AAP).
However, parents who don't want their kids to adhere to these guidelines
can seek special permission for an exemption. The question is whether that
will be the case with the COVID-19 vaccine.

"The vaccines are safe, the vaccines are effective, and they are a good way
to keep our kids healthy and to keep our kids in school," says Talaat.
"Having said that, mandates do work, but they have a lot of pushback
against them, so encouraging people and trying to get people to be
vaccinated voluntarily might be a better way to do that."

Schools might consider several factors in determining whether or not

children should be required to receive the COVID-19 vaccine to attend
school.
Full FDA Approval
The Johnson & Johnson vaccine, along with the Pfizer-BioNTech vaccine for
kids under 16, are being distributed "under an emergency use
authorization [EUA], which is a much shorter process than what is required
for a vaccine to be fully approved by the FDA," says Reagan Anderson, DO,
FAOCD, FAAD, FASMS, MPH, and former combat physician.

The Moderna vaccine received FDA approval for people 18 years and up on
January 31, 2022.2 Full FDA approval is a lengthy process that involves
evaluating data from the vaccine manufacturer, including:1

 Details about the manufacturing process

 Inspection of the vaccine facilities
 Preclinical and clinical data
 Vaccine testing results

This process usually takes years; however, the full approval of the Pfizer
vaccine for 16 and older came less than a year after its EUA. It isn't clear
whether a timeline for full FDA approval of a children's vaccine will follow a
similar pattern.

I would expect that we are going to see it fully

approved for 12- to 15-year-olds before it’s
approved for 5- to 11-year-olds and as we work
down in age.
— KAWSAR TALAAT, MD

"It requires so much work on behalf of the people who are applying as well
as those who are reviewing," says Talaat. "I would expect that we are going
to see it fully approved for 12- to 15-year-olds before it's approved for 5- to
11-year-olds, and as we work down in age."

The lack of full FDA approval doesn't mean the vaccine is unsafe by any
measure, only that schools may have difficulty mandating something that
hasn't yet received FDA approval like other required vaccinations.

Vaccines for children ages 5 to 15 are currently operating under emergency

use authorization (EUA). Full FDA approval is a lengthier process, which
some school districts may wait on before discussing COVID-19 vaccine
mandates.

The Risks of Kids Spreading COVID

Scientists now know that kids spread the virus the same as adults. That
means they can spread COVID-19 in lots of circumstances, including: 3

 When they are asymptomatic

 When they have mild symptoms
 When they have non-specific symptoms
 When they don't know they are infected

When a community has higher rates of COVID-19 infection, it is more likely

that COVID-19 will spread in local schools.3 Layered prevention strategies as
recommended by the Centers for Disease Control and Prevention (CDC).

These measures, which include wearing masks, getting vaccinated, physical

distancing, testing, and screening, all reduce the risk of COVID-19
transmission in schools. However, not all schools adhere to such guidelines.

The Risk of the Virus Compared to the

Vaccine
Finally, one of the most prominent factors schools will have to consider when
it comes to potential COVID vaccine requirements is the fact that kids are
often mildly affected by the virus.

As of January 27, 2022, more than 11.4 million American children have been
infected with COVID-19. Nearly one million of those cases occurred in the
last week of January 2022. Since the pandemic began, children have made
up 18.6% of cases.4

Yes, it’s a generally mild disease in kids, but it can

be an incredibly serious disease in kids, and it can
be a fatal disease in kids, and the best way to
prevent that and to keep them healthy is by
vaccinating them.
— KAWSAR TALAAT, MD

Children accounted for 1.6% to 4.4% of hospitalizations among states

reporting data.4 In addition, as of February 2022, 623 kids ages 5 to 18 and
287 kids under 5 have died from COVID-19.5

"Yes, it's a generally mild disease in kids," says Talaat, "but it can be an
incredibly serious disease in kids, and it can be a fatal disease in kids, and
the best way to prevent that and to keep them healthy is by vaccinating
them."